Surgical instrument having a common trigger for actuating an end effector closing system and a staple firing system

ABSTRACT

A surgical instrument including a trigger which can be configured to close a jaw member upon a first actuation of the trigger and advance a staple driver and/or cutting member upon a subsequent, or second, actuation of the trigger. Such a surgical instrument can allow a surgeon to position the surgical instrument in a surgical site and close the jaw member with an initial actuation of the trigger without deploying any staples into, or incising, the tissue. As a result, the surgeon can manipulate the position of the surgical instrument and then actuate the trigger a second time to deploy staples into, and/or incise, the tissue. In at least one such embodiment, the first actuation of the trigger which closes the jaw member can also unlock a firing drive configured to advance the staple driver and cutting member during the second actuation of the trigger.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is related to the following commonly-owned U.S.patent applications filed concurrently herewith, and which are herebyincorporated by reference in their entirety:

(1) U.S. patent application Ser. No. ______, entitled SURGICALINSTRUMENT HAVING A DIRECTIONAL SWITCHING MECHANISM, Atty. Docket No.070058/END6088USNP; and

(2) U.S. patent application Ser. No. ______, entitled SURGICALINSTRUMENT HAVING A MULTIPLE RATE DIRECTIONAL SWITCHING MECHANISM, Atty.Docket No. 070059/END6089USNP.

BACKGROUND

1. Field of the Invention

The present invention generally relates to surgical stapling instrumentsand, more particularly, to surgical staplers having a trigger configuredto actuate both an end effector closing system and a firing system fordeploying staples.

2. Description of the Related Art

As known in the art, surgical staplers are often used to deploy staplesinto soft tissue to reduce or eliminate bleeding from the soft tissue,especially as the tissue is being transected, for example. Surgicalstaplers, such as an endocutter, for example, often comprise an endeffector which is configured to secure the soft tissue between first andsecond jaw members. The first jaw member often includes a staplecartridge which is configured to removably store staples therein and thesecond jaw member often includes an anvil. In use, the staples aretypically deployed from the staple cartridge by a driver which traversesa channel in the staple cartridge and causes the staples to be deformedagainst the anvil and secure layers of the soft tissue together. Often,as known in the art, the staples are deployed in several staple lines,or rows, in order to more reliably secure the layers of tissue together.The end effector may also include a cutting member, such as a knife, forexample, which is advanced between two rows of the staples to resect thesoft tissue after the layers of the soft tissue have been stapledtogether.

After the driver and the cutting member have been advanced within theend effector, it is often necessary to retract the driver and/or cuttingmember to their starting positions. Previous surgical staplers haveincluded a return spring which retracts the cutting member relative tothe staple cartridge after a release button or toggle switch on thesurgical stapler has been actuated by the surgeon. Such staplers,however, are unable to partially retract the cutting member and, as aresult, the cutting member must be fully retracted before it can bereadvanced. Other previous surgical staplers have included a pluralityof triggers which are operatively engaged with systems for closing a jawmember and for advancing and/or retracting the driver and cuttingmember. Such devices, while suitable for their intended purposes, oftenrequire a surgeon to release a trigger operably engaged with the closingsystem and reposition their hand to grasp a different trigger which isoperatively engaged with a system for advancing the staple driver andcutting member. While previous surgical staplers have been developedwhich have a single trigger for both closing the jaw member andadvancing the driver and cutting member, such devices perform bothfunctions upon the initial actuation of the trigger. While suitable insome circumstances, devices which perform both functions in the sametrigger actuation are often exceedingly difficult to operate owing tothe high degree of force required to actuate the trigger. Furthermore,such devices, as they close the jaw member and deploy staples in thesame trigger actuation, do not afford the surgeon with an opportunity toevaluate the position of the closed jaw member and reposition the jawmember before the staples are deployed into the soft tissue. What isneeded is an improvement over the foregoing.

SUMMARY

In at least one form of the invention, a surgical instrument can includea switching mechanism which can allow a surgeon, or other clinician, toselectively advance or retract a staple driver and/or cutting memberwithin a staple cartridge. In various embodiments, the surgicalinstrument can include a handle, a trigger operatively coupled to thehandle, a firing drive, and an end effector. In at least one embodiment,the firing drive can include a first ratchet assembly configured toadvance a cutting member in the end effector and a second ratchetassembly configured to retract the cutting member. In variousembodiments, the trigger can include first and second pawls pivotablymounted thereon which are configured to be selectively engaged with thefirst and second ratchet assemblies, respectively. In at least one suchembodiment, the trigger can be configured to slide between a firstposition in which the first pawl is engaged with the first ratchetassembly and a second position in which the second pawl is engaged withthe second ratchet assembly. In such embodiments, a surgeon can quicklyand conveniently select between advancing and retracting motions of thecutting member.

In at least one form of the invention, a surgical instrument can includea drive mechanism configured to advance a staple driver and/or cuttingmember at a first rate and retract the staple driver and/or cuttingmember at a different rate. In at least one embodiment, the rate atwhich the driver and cutting member are advanced and/or retracted is thedistance that the driver and cutting member are translated peractuation, or stroke, of a trigger, for example. Accordingly, in suchembodiments, a first rate is considered to be faster than a second rateif the trigger advances or retracts the cutting member a greaterdistance per actuation. In various embodiments, the cutting member canbe retracted at a faster rate as compared to the rate in which it isadvanced. In such embodiments, the surgical instrument can, owing to theslower advancing rate, provide a greater torque or advancing force tothe cutting member while, owing to the faster retracting rate, reducethe time required for the surgeon to retract the cutting member. Invarious embodiments, as described above, the surgical instrument caninclude a switching mechanism configured to selectively engage one of afirst drive system and a second drive system with a rotatable driveshaft. In at least one such embodiment, the first drive system caninclude a first gear having a first pitch radius and the second drivesystem can include a second gear having a different pitch radius wherethe first and second gears can rotate the drive shaft at differentrates.

In at least one form of the invention, a surgical instrument can includea trigger which can be configured to close a jaw member onto softtissue, for example, upon a first actuation of the trigger and advance astaple driver and/or cutting member upon a subsequent, or second,actuation of the trigger. In various embodiments, such a surgicalinstrument can allow a surgeon to position the surgical instrument in asurgical site and close the jaw member with an initial actuation of thetrigger without deploying any staples into, or incising, the tissue. Insuch embodiments, as a result, the surgeon can manipulate the positionof the surgical instrument and then actuate the trigger a second time todeploy staples into, and/or incise, the tissue. In at least one suchembodiment, the first actuation of the trigger which closes the jawmember can also unlock a firing drive configured to advance the stapledriver and cutting member during the second actuation of the trigger. Invarious embodiments, the surgical instrument can include a switchingmechanism which can allow the surgeon to reopen the jaw member and, ifthey so choose, to reposition the jaw member in a more suitableposition.

BRIEF DESCRIPTION OF THE DRAWINGS

The above-mentioned and other features and advantages of the variousembodiments of this invention, and the manner of attaining them, willbecome more apparent and the invention itself will be better understoodby reference to the following description of embodiments of theinvention taken in conjunction with the accompanying drawings, wherein:

FIG. 1 is a perspective view of a surgical instrument in accordance withan embodiment of the present invention;

FIG. 2 is an exploded view of a shaft portion and end effector of thesurgical instrument of FIG. 1;

FIG. 3 is an exploded view of a handle portion of the surgicalinstrument of FIG. 1;

FIG. 4 is partial side view of the handle portion of FIG. 3 with somecomponents of the surgical instrument removed;

FIG. 5 is a top view of the handle portion of FIG. 3 with somecomponents of the surgical instrument removed illustrating the surgicalinstrument in a configuration for advancing a cutting member in the endeffector;

FIG. 6 is a bottom view of the handle portion of FIG. 3 with somecomponents of the surgical instrument removed illustrating the surgicalinstrument in a configuration for advancing a cutting member in the endeffector;

FIG. 7 is a partial perspective view of the handle portion of FIG. 3with some components of the surgical instrument removed;

FIG. 8 is a perspective view of the surgical instrument of FIG. 1illustrating the configuration of the surgical instrument upon the firstactuation of the trigger;

FIG. 9 is a partial perspective view of the surgical instrument of FIG.1 in the configuration illustrated in FIG. 8 with some components of thesurgical instrument removed;

FIG. 10 is a perspective view of a cam of the end effector closuresystem of the surgical instrument of FIG. 1;

FIG. 11 is an elevational view of the cam of FIG. 10 illustratingvarious relative positions of a lock of the anvil closure system;

FIG. 12 is a perspective view of the surgical instrument of FIG. 1illustrating the configuration of the surgical instrument after thetrigger has been released after the first actuation of the trigger;

FIG. 13 is a perspective view of the surgical instrument of FIG. 1illustrating the configuration of the surgical instrument upon thesecond actuation of the trigger;

FIG. 14 is a partial perspective view of the surgical instrument of FIG.1 in the configuration illustrated in FIG. 13;

FIG. 15 is a perspective view of the surgical instrument of FIG. 1illustrating the configuration of the surgical instrument upon the thirdactuation of the trigger;

FIG. 16 is a perspective view of the surgical instrument of FIG. 1illustrating the configuration of the surgical instrument upon thefourth actuation of the trigger;

FIG. 17 is a perspective view of the surgical instrument of FIG. 1illustrating the configuration of the surgical instrument after thetrigger has been released after the fourth actuation of the trigger andthe switching mechanism of the surgical instrument has been operated;

FIG. 18 is a perspective view of the surgical instrument of FIG. 1illustrating the configuration of the surgical instrument upon theseventh actuation of the trigger with the cutting member fullyretracted;

FIG. 19 is a partial elevational view of the surgical instrument of FIG.1 illustrated in the configuration of FIG. 18 with components of thesurgical instrument removed;

FIG. 20 is a partial perspective view of the housing of the surgicalinstrument of FIG. 1 illustrating the interaction of the firing driveand the housing after the seventh actuation of the trigger;

FIG. 21 is a perspective view of a gear reduction mechanism for asurgical instrument in accordance with an alternative embodiment of thepresent invention with a portion of the gear reduction housingdisassembled;

FIG. 22 is an exploded view of the gear reduction mechanism of FIG. 21;

FIG. 23 is a perspective view of a surgical instrument in accordancewith an alternative embodiment of the present invention;

FIG. 24 is an exploded view of the end effector and shaft assembly ofthe surgical instrument of FIG. 23;

FIG. 25 is an exploded view of the handle portion of the surgicalinstrument of FIG. 23;

FIG. 26 is an exploded view of the surgical instrument of FIG. 23 withcomponents of the surgical instrument removed;

FIG. 27 is a perspective view of the surgical instrument of FIG. 23 withcomponents of the surgical instrument removed;

FIG. 28 is a second perspective view of the surgical instrument of FIG.23 with components of the surgical instrument removed;

FIG. 29 is a side view of the surgical instrument of FIG. 23 configuredto advance a cutting member within the end effector;

FIG. 30 is a side view of the surgical instrument of FIG. 23 configuredto retract the cutting member within the end effector;

FIG. 31 is a perspective view of a directional switching mechanism inaccordance with an alternative embodiment of the present invention withsome components disassembled and other components illustrated incross-section;

FIG. 32 is a plan view of the directional switching mechanism of FIG. 31with some components removed and other components illustrated incross-section; and

FIG. 33 is a diagram of a bistable compliant mechanism in accordancewith an alternative embodiment of the present invention.

Corresponding reference characters indicate corresponding partsthroughout the several views. The exemplifications set out hereinillustrate preferred embodiments of the invention, in one form, and suchexemplifications are not to be construed as limiting the scope of theinvention in any manner.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those of ordinary skill in the art will understand that thedevices and methods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the various embodiments of the present invention is definedsolely by the claims. The features illustrated or described inconnection with one exemplary embodiment may be combined with thefeatures of other embodiments. Such modifications and variations areintended to be included within the scope of the present invention.

In various embodiments, a surgical instrument in accordance with thepresent invention can include systems for inserting surgical staplesinto soft tissue, for example. In at least one embodiment, the surgicalinstrument can include a staple cartridge configured to removably storestaples therein and an anvil for deforming the staples as they aredeployed from the staple cartridge. In order to deploy the staples, thesurgical instrument can include a staple driver configured to traversethe staple cartridge and a firing drive for advancing the staple driverwithin the staple cartridge. In various embodiments, the firing drivecan include a drive bar which is translated in a substantially lineardirection by a trigger operably engaged therewith. In other embodiments,the firing drive can include a drive shaft which is rotated by thetrigger. In such embodiments, the surgical instrument can include ashaft assembly which can convert the rotary motion of the drive shaftinto linear motion and translate the staple driver within the staplecartridge. While the exemplary embodiment illustrated in FIGS. 1-20 anddescribed below includes a firing drive having a rotary drive shaft, thepresent invention is not so limited. Furthermore, while a generaldescription of a firing drive having a rotary drive shaft is providedbelow, other such devices are described and illustrated in greaterdetail in the commonly-owned, co-pending U.S. patent application Ser.No. 11/475,412, entitled MANUALLY DRIVEN SURGICAL CUTTING AND FASTENINGINSTRUMENT and filed on Jun. 27,2006, the entire disclosure of which ishereby incorporated by reference herein.

Referring to FIG. 1, surgical instrument 50 can include handle portion52, trigger 54, elongate shaft assembly 56, and end-effector 58. Invarious embodiments, end-effector 58 can include anvil 62 and staplecartridge channel 64, where channel 64 can be configured to receivestaple cartridge 66 and anvil 62 can be pivotably connected to channel64. In at least one embodiment, at least one of anvil 62 and channel 64can be operably connected to trigger 54 such that, upon an actuation oftrigger 54, anvil 62 can be rotated into a closed position asillustrated in FIG. 8. In various embodiments, referring to FIGS. 2-4,trigger 54 can be operably engaged with a closure drive systemconfigured to translate both anvil 62 and channel 64 relative to outersheath 57 of elongate shaft assembly 56. Referring primarily to FIG. 4,the closure drive can include cam 68 operably engaged with trigger 54such that a first actuation of trigger 54 can rotate cam 68 about pin 70and drive closure links 72 in a substantially linear direction. Moreparticularly, trigger 54 can include lift pin 55 (FIG. 3) extendingtherefrom which can be configured to contact surface 71 of cam 68 andlift cam 68 into the position illustrated in FIG. 8. Cam 68 can furtherinclude cam slot 69 where, when cam 68 is rotated from its positionillustrated in FIG. 4 to its position illustrated in FIG. 8, the sidewalls of cam slot 69 can engage closure link pin 76 and, in the presentembodiment, slide closure links 72 in a direction illustrated by arrow A(FIG. 4).

Referring to FIGS. 2 and 4, surgical instrument 50 can further include aspine assembly within elongate shaft assembly 56 (FIG. 1), where thespine assembly can include proximal channel portion 78 and distalchannel portion 80. In various embodiments, channel portions 78 and 80can be interconnected by the cooperative engagement of projection, ortongue, 84 and groove 86. More particularly, referring to FIG. 2,proximal channel portion 78 can include, in various embodiments, firsthalf 77 and second half 79 which can be assembled to distal channelportion 80 such that projection 84 is secured within groove 86. In atleast one embodiment, proximal channel portion halves 77 and 79 caninclude projections 81 and/or apertures 83 configured to provide asnap-fit or press-fit engagement between proximal channel portion halves77 and 79. In various other embodiments, channel portions 78 and 80 canbe interconnected by any suitable means and, in at least one embodiment,although not illustrated, portions 78 and 80 can be integrally formed.Similar to the above, referring to FIG. 2, distal channel portion 80 caninclude distal end 88 which can be connected to staple cartridge channel64. More particularly, distal channel portion 80 and staple cartridgechannel 64 can include cooperating tongue and groove features, forexample, which can provide a press-fit or snap-fit interconnectiontherebetween, although any other suitable interconnection therebetweencan be used.

Referring to FIG. 4, proximal end 82 of channel portion 78 can becoupled to closure links 72 by pin 53 such that, when closures links 72are translated by cam 68, channel portion 78 is translated withinelongate shaft assembly 56. In at least one embodiment, channel portion78 can further include projections 87 extending therefrom which can beconfigured to slide within recesses 85 (FIG. 3) in housing portions 90and substantially limit the translation of channel portion 78 along anaxis. As staple cartridge channel 64 is connected to proximal channelportion 78 via distal channel portion 80, channel 64, and anvil 62pivotably connected thereto, can be moved in direction A when cam 68 isrotated by trigger 54 as described above. In at least one embodiment,referring to FIG. 2, proximal end 63 of anvil 62 can be configured toabut outer sheath 57 of elongate shaft assembly 56 when channel 64 andanvil 62 are translated relative to sheath 57. After proximal end 63 ofanvil 62 contacts outer sheath 57, anvil 62 can be configured to rotatetoward channel 64 and staple cartridge 66 in order to close anvil 62 asillustrated in FIG. 8. In various embodiments, referring to FIG. 2,channel 64 can include slots 65 therein which can be configured to guideanvil 62 as it is pivoted relative to channel 64. Once anvil 62 isclosed, the surgical instrument can further include a lock which holdsanvil 62 in its closed position. In various embodiments, referring toFIGS. 9-11, surgical instrument 50 can include spring lock 92 mounted tohousing 90, where spring lock 92 can be configured to releasably holdcam 68 in position which, as a result, locks closure links 72, channelportions 78 and 80, channel 64, and anvil 62 in position until a surgeondesires to open anvil 62 as described in detail further below.

In various embodiments, after anvil 62 has been placed into its closedposition, trigger 54 can be actuated a second time to operate a firingdrive which advances cutting member 96 within end effector 58. In atleast one embodiment, the firing drive can be disengaged from trigger 54prior to the first actuation of trigger 54. In such embodiments, thefirst actuation of trigger 54 can operably engage trigger 54 with thefiring drive and/or release a component of the firing drive such thatthe firing drive becomes operably engaged with trigger 54. In theillustrated embodiment, referring to FIGS. 3 and 4, the firing drive caninclude trigger gear portion 100 extending from trigger 54, gear train102, gear carriage 130, and rotatable drive shaft 106 which can beconfigured to advance cutting member 96 within end effector 58 asdescribed in greater detail below. As illustrated in FIGS. 3-7, geartrain 102 can include ratchet gear 108, main drive gear 110, bevel drivegear 112, and bevel gear 114 where, prior to the first actuation oftrigger 54, cam 68 can be configured to bias ratchet gear 108 out ofengagement with main drive gear 110. More particularly, referring toFIG. 3, ratchet gear 108 can include shaft 116 and collar 118 where cam68 can be configured to contact collar 118 and bias ratchet gear 108away from main drive gear 112 such that ratchet face 109 on ratchet gear108 is not engaged with ratchet face 111 on main drive gear 110.

Upon the first actuation of trigger 54, as described above, cam 68 canbe rotated into the position illustrated in FIG. 8 and, as a result ofsuch rotation, groove 120 (FIGS. 4 and 5) in cam 68 can be configured torelease ratchet gear 108. More particularly, referring to FIGS. 5-7,groove 120 can be dimensioned such that, when the rotation of cam 68aligns groove 120 with collar 118, collar 118 can slide past cam 68 andallow ratchet spring 122 to bias ratchet gear 108 into operativeengagement with main drive gear 110. Thereafter, trigger 54 can bereleased and then returned to its starting position by trigger spring124 where trigger spring 124 can be connected to pin 126 extending fromhousing 90 and pin 128 extending from trigger 54. Notably, eventhoughtrigger 54 can be returned to its starting position, cam 68 can remainlocked in its second position by lock 92, as described above, therebymaintaining the alignment between groove 120 and collar 118. Withratchet gear 108 now operably engaged with drive gear 110, a secondactuation of trigger 54 can advance cutting member 96 and the stapledriver within end effector 58.

Referring primarily to FIGS. 3 and 4, an actuation of trigger 54 canrotate trigger gear portion 100 about an axis defined by pin 70. Triggergear portion 100 can include gear teeth extending along the perimeterthereof which can, referring to FIGS. 5 and 6, be engaged with gearteeth extending around the circumference, for example, of ratchet gear108. In use, as a result, the actuation, or rotation, of trigger 54 canrotate ratchet gear 108 about an axis defined by shaft 116 and pin 117(FIG. 3). As described above, ratchet gear 108 can, referring to FIGS. 5and 6, include ratchet face 109 which can be configured to engageratchet face 111 of main drive gear 110. In at least one embodiment,ratchet faces 109 and 111 can be configured to transmit the rotationalmotion of trigger 54 to main drive gear 110 upon the second actuation,or other subsequent actuation, of trigger 54 but also permit relativesliding movement therebetween when trigger 54 is released and returnedto its unactuated position. In effect, ratchet faces 109 and 111 can beconfigured to transmit rotational motion to main drive gear 110 whenratchet gear 108 is rotated in one direction but not transmit rotationalmotion to main drive gear 110 when ratchet gear 108 is rotated in theopposite direction. Although a ratchet mechanism has been described andillustrated herein, any other suitable mechanism for transmitting motionbetween trigger 54 and main drive gear 110 can be used. Furthermore,although trigger 54 has been described and illustrated as a lever, anyother suitable device can be used to motivate the firing and closingdrives described herein.

Referring primarily to FIGS. 5-7, main drive gear 110 can include gearteeth extending around the circumference thereof, for example, which canbe engaged with gear teeth extending around the perimeter, for example,of bevel drive gear 112. In use, as a result, the rotational motiontransmitted to main drive gear 110 from ratchet gear 108, for example,can be transmitted to bevel drive gear 112. In various embodiments,bevel drive gear 112 can be mounted to or integrally formed with shaft113, where shaft 113 can define an axis about which bevel drive gear 112can be rotated. In at least one embodiment, referring to FIG. 3,surgical instrument 50 can further include bracket 115 about which beveldrive gear 112 and shaft 113 can be rotated. As described in greaterdetail below, bracket 115 can also include supports 119 which can beconfigured to slidably support at least a portion of gear carriage 130.In various embodiments, referring to FIGS. 5-7, bevel gear 114 can beattached to bevel drive gear 112 or, alternatively, bevel gear 114 canbe mounted to or integrally formed with shaft 113. In either event, therotational motion transmitted to bevel drive gear 112 can be transmittedto bevel gear 114.

In various embodiments, although not illustrated, bevel gear 114 couldbe directly engaged with drive shaft 106 via cooperating bevel gearteeth. In at least one such embodiment, bevel gear 114 could rotatedrive shaft 106 in a clockwise direction, for example, and advancecutting member 96 within end effector 58 as described below. In suchembodiments, the actuation of trigger 54 could advance cutting member 96within end effector 58, however, cutting member 96 would have to beretracted either manually or via an additional retraction system. In theillustrated embodiment of the present invention, referring to FIGS. 3and 5-7, surgical instrument 50 can further include a switchingmechanism which can allow drive shaft 106 to be rotated in either aclockwise or counter-clockwise direction and, correspondingly, allowcutting member 96 to be advanced or retracted via the actuation oftrigger 54. In various embodiments, referring primarily to FIGS. 5 and6, the switching mechanism can include gear carriage 130 which can beshifted between a first position in which the rotational motion of bevelgear 114 rotates drive shaft 106 in a clockwise direction, for example,and a second position in which the rotational motion of bevel gear 114rotates drive shaft 106 in a counter-clockwise direction.

In various embodiments, referring to FIGS. 5-7, gear carriage 130 caninclude housing 132, forward gear 134, and reversing gear 136 whereforward gear 134 and reversing gear 136 can be rotatably mounted tohousing 132. In at least one embodiment, drive shaft 106 can includesubstantially hex-shaped end 107, for example, which can be receivedwithin apertures (not illustrated) in forward gear 134 and reversinggear 136 such that gears 134 and 134 are rotatably engaged with driveshaft 106. In other various embodiments, end 107 can include any othersuitable shape or configuration such that gears 134 and 136 arerotatably engaged with drive shaft 106. In either event, referring toFIG. 5, gear carriage 130 can be slid along end 107 such that eitherforward gear 134 or reversing gear 136 can be engaged with bevel gear114. In use, when forward gear 134 is engaged with bevel gear 114, forexample, the rotational motion of bevel gear 114 can be transmitted toforward gear 134 and, owing to cooperating geometries of end 107 and theaperture in forward gear 134, the rotational motion of gear 134 can betransmitted to drive shaft 106. In order to rotate drive shaft in theopposite direction, gear carriage 130 can be slid proximally, orrearward, such that reversing gear 136 engages bevel gear 114. Amechanism for motivating gear carriage 130 in this manner is describedfurther below.

In various embodiments, when forward gear 134 is engaged with bevel gear114, as illustrated in FIG. 5, reversing gear 136 can be disengaged frombevel gear 114 such that reversing gear 136 is free to rotate with driveshaft 106. In at least one embodiment, gear carriage 130 can furtherinclude spacer 135 which can be configured to rotatably support andalign gears 134 and 136 yet permit gears 134 and 136 to rotateindependent of one another. In some embodiments, gear carriage 130 canbe placed in a position intermediate the forward and rearward positionssuch that both gears 134 and 136 engage bevel gear 114 and hold driveshaft 106 in a ‘locked-out’ condition such that trigger 54 cannot beactuated. In other various embodiments, gear carriage 130 can be placedin an intermediate position such that neither gears 134 and 136 engagebevel gear 114. In such embodiments, the firing drive is in a ‘free’condition and the rotational motion of bevel gear 114 is not transmittedto drive shaft 106.

In various embodiments, referring primarily to FIG. 2, drive shaft 106can further include threaded drive portion 138 which can be operablyengaged with firing nut 140. In at least one embodiment, threaded driveportion 138 can be configured to slidably advance and/or retract firingnut 140 in response to rotational motion of drive shaft 106. Moreparticularly, firing nut 140 can include threaded aperture 141 which canbe configured to threadably receive threaded drive portion 138 such thatthe rotation of drive shaft 106 produces a reactional force whichadvances firing nut 140 distally. In at least one embodiment, firing nut140 can include projection 142 extending therefrom which can beconfigured to extend through a slot defined between proximal channelportion halves 77 and 79 in order to constrain the movement of firingnut 140 along an axis. In effect, the slot can prevent firing nut 140from rotating with drive shaft 106 and can define a path for projection142 as firing nut 140 is translated within channel portion 78.

In various embodiments, referring to FIG. 2, cutting member 96 can beoperably engaged with firing nut 140 such that the translation of firingnut 140, as described above, can result in the translation of cuttingmember 96 within end effector 58. In at least one embodiment, surgicalinstrument 50 can further include firing rod 144 connected to firing nut140, drive bar 146 connected to cutting member 96, and adapter 148configured to connect drive bar 146 to firing rod 144. In variousembodiments, firing rod 144 can include proximal end 145 which caninclude an aperture configured to receive at least a portion of firingnut 140 in a press-fit manner. In at least one embodiment, proximal end145 of firing rod 144 can include deformable member 147 which can beconfigured to engage recess 143 in firing nut 140 after deformablemember 147 has been depressed or deformed inwardly toward recess 143. Ineither event, firing rod 144 can further include distal end 149 whichcan be configured to receive plug 150 in a press-fit manner, forexample, where plug 150 can include projection 152 extending therefromwhich can be received within slot 154 in adapter 148. In variousembodiments, adapter 148 can further include slot 15 1, where slot 151can be configured to receive connector tab 154 of drive bar 146 suchthat, when adapter 148 is translated by firing rod 144, drive bar 146can be translated within distal retainer section 80. In at least oneembodiment, drive bar 146 can further include distal end 156 which canbe configured to engage recess 97 in cutting member 96 and advanceand/or retract cutting member 96 within end effector 58. As describedabove, cutting member 96 can include knife 99 which can be configured toincise tissue positioned between anvil 62 and staple cartridge 66 ascutting member 96 is advanced within end effector 58. Further, asdescribed above, cutting member 96 can include portion 95, where portion95 can be configured to push a staple driver (not illustrated) withinstaple cartridge 66 to deploy staples (not illustrated) removably storedtherein.

In various embodiments, the surgical instrument can be configured toadvance cutting member 96 a desired distance upon a single actuation oftrigger 54, i.e., the second overall actuation of trigger 54 inembodiments where the first actuation of trigger 54 closes anvil 62 asdescribed above. In other embodiments, however, more than one actuationof trigger 54 can be used to advance cutting member 96 a desireddistance. In at least one such embodiment, referring to FIGS. 12-16,trigger 54 can be actuated three times to advance cutting member 96 fromproximal end 59 to distal end 61 of end effector 58. The quantity ofsuch actuations in other embodiments, however, will depend largely uponthe overall distance that cutting member 96 is to be displaced and thedisplacement of cutting member 96 as a result of each actuation.Notably, prior to the second actuation of trigger 54, cutting member 96can be positioned in proximal end 59 of end effector 58 and firing nut140 can be positioned in its most proximal position. Upon the secondactuation of trigger 54, referring to FIGS. 13 and 14, cutting member 96can be advanced approximately one-third of the distance between proximalend 59 and distal end 61 and, similarly, firing nut 140 can be advanceddistally along drive shaft 106. Thereafter, referring to FIG. 15,cutting member can be advanced an additional one-third of the distancebetween proximal end 59 and distal end 61 upon the third actuation oftrigger 54 and, similarly, referring to FIG. 16, cutting member 96 canbe advanced into distal end 61 of end effector 58 upon the fourthactuation of trigger 54.

In various embodiments, in order to assist a surgeon in monitoring theamount of times that trigger 54 has been actuated, surgical instrument50 can include a counting mechanism which can be configured to displaythe amount of times that trigger 54 has been actuated and/or the amountof actuations remaining to deploy all of the staples in the staplecartridge. In either event, referring primarily to FIGS. 3 and 9, oneembodiment of counting mechanism 170 can include indicator nut 172,indicator plate 174, and indictor window 171 (FIG. 1) in housing 90. Inat least one embodiment, indicator plate 174 can include indicia thereonwhich can communicate to the surgeon the amount of times that trigger 54has been actuated to advance cutting member 96. In such embodiments,indicator plate 174 can include blank portion 173 which is visiblethrough window 171 before and after the first actuation of trigger 54,i.e., the actuation of trigger 54 which closes anvil 62 as describedabove. Upon the second actuation of trigger 54, the rotation of driveshaft 106 can advance indicator nut 172 and indicator plate 174, whichis mounted to indicator nut 172, distally such that the numeral “1” orother appropriate indicia on indicator plate 174 can be seen throughindicator window 171. Accordingly, such an indicium can indicate to thesurgeon that cutting member 96 has been advanced by one actuation oftrigger 54. Similar to firing nut 140, indicator nut 172 can include athreaded aperture which can be threadably engaged with threaded portion176 of drive shaft 106 such that the rotation of drive shaft 106 appliesa reactional force to indicator nut 172 and advances it distally.Subsequent actuations of trigger 54 can move the numerals ‘2’ and ‘3’beneath indicator window 171.

In order to retract cutting member 96, as outlined above, gear carriage130 can be shifted such that forward gear 134 is disengaged from bevelgear 114 and, referring to FIGS. 17 and 18, reversing gear 136 isengaged with bevel gear 114. Thereafter, subsequent actuations oftrigger 54 can rotate drive shaft 106 in the opposite direction andtranslate firing nut 140 proximally. More particularly, owing to thethreaded engagement between firing nut 140 and threaded portion 138 ofdrive shaft 106, the rotation of shaft 106 in the opposite directionapplies a reactional force to firing nut 140 which displaces firing nut140 in the proximal direction. Accordingly, firing rod 144, drive bar146 and cutting member 96, which can be connected to firing nut 140 asdescribed above, are also displaced in the proximal direction therebyretracting cutting member 96 within end effector 58. Similarly, therotation of shaft 106 in the opposite direction can displace indictornut 172 of indicator assembly 170 proximally as well. More particularly,the first actuation of trigger 54 after gear carriage 130 has beenshifted, i.e., the fifth overall actuation of trigger 54, can causedrive shaft 106 to apply a reactional force to indicator nut 172 andmove nut 172 proximally. In such circumstances, indicator nut 172 canmove indicator plate 174 relative to window 171 such that the numeral‘2’ is visible through indicator window 171 which can remind the surgeonthat two more actuations of trigger 54 are required to fully retractcutting member 96.

Although trigger 54 is actuated three times to advance and/or retractcutting member 96 in the present embodiment, the actuations required toadvance cutting member 96 can be different than the actuations requiredto retract cutting member 96 in other embodiments. Exemplary embodimentsincluding features for advancing and retracting cutting member 96 atdifferent rates are described in detail further below. Furthermore, inat least one embodiment, portion 95 of cutting member 96 can be engagedwith the staple driver such the retraction of cutting member 96 alsoretracts the staple driver. In other embodiments, however, the stapledriver can be left behind in the staple cartridge and only the cuttingmember 96 is retracted. Such embodiments may be utilized where a spentstaple cartridge assembly is replaced with a new staple cartridgeassembly which includes its own staple driver therein and, as a result,it may be desirable to leave the used staple driver in the spentcartridge.

In order to motivate gear carriage 130 as described above, surgicalinstrument 50 can include, referring to FIGS. 3-5, switching mechanism160. In at least one embodiment, switching mechanism 160 can includeshaft switch 162, shifter handles 164 extending therefrom, and shifterlink 166, where shifter link 166 can be connected to shaft 162 viashifter pin 169 and gear carriage housing 132 via pin 168. In order toslide gear carriage 130 relative to drive shaft 106 as described above,shifter handles 164 can be configured to rotate shaft 162 such thatcrank arm 163 extending from shaft 162 displaces shifter link 166 anddrives gear carriage 130 along axis 105 of drive shaft 106. In theillustrated embodiment, when shifter handles 164 are oriented in asubstantially downward direction, as illustrated in FIG. 8, crank arm163 is oriented in a substantially upward direction. In thisconfiguration, referring to FIG. 5, gear carriage 130 is positioned inits most rearward, or proximal, position such that forward gear 134 isoperably engaged with bevel gear 114. In order to shift surgicalinstrument 50 into a configuration in which cutting member 96 isretracted, shifter handles 164 can be rotated upwardly, as illustratedin FIG. 17, to rotate crank arm 163 forward, or distally.Correspondingly, crank arm 163 can be configured to displace link arm166 distally and pull gear carriage 130 into its most distal position,thereby engaging reversing gear 136 with bevel gear 114. In the eventthat the surgeon desires to advance cutting member 96 after at leastpartially retracting cutting member 96, the surgeon can rotate shifterhandles 164 downwardly and re-engage forward gear 134 with bevel gear114.

In various embodiments, referring to FIGS. 3 and 5, surgical instrument50 can further include a bistable compliant mechanism for biasingswitching mechanism 160 into a configuration where one of gears 134 or136 is engaged with bevel gear 114. Stated another way, the bistablecompliant mechanism can cause switching mechanism 160 to becomedynamically unstable when a surgeon only partially rotates shifterhandles 164. In such circumstances, the bistable compliant mechanism canbias switching mechanism 160 into one of two configurations where it isstable, i.e., the forward and reversing configurations. In variousembodiments, bistable compliant mechanism 180, referring primarily toFIG. 3, can include receiver 182, spring 184, plunger 186 and toggle pin188. In at least one embodiment, toggle pin 188 can connect plunger 186to switch shaft 162 and receiver 182 can be connected to projection 183extending from housing 90. In use, spring 184 can be configured to applya biasing force to shaft 162 via plunger 186 and can be configured torotate shaft 162 in the event that shaft 162 is only partially rotatedbetween its forward and reversing orientations.

In various embodiments, once cutting member 96 has been fully retracted,the end effector closing system and the staple firing system can bereset so that the spent staple cartridge can be removed from surgicalinstrument 50, a new staple cartridge 66 can be positioned within staplecartridge channel 64, and surgical instrument 50 can be used to furtherstaple and cut tissue as described above. In the illustrated embodiment,cam 68 can be released from lock 92 to open anvil 62 and reset the endeffector closure system. Similarly, ratchet gear 108 can be disengagedfrom main drive gear 110 to disengage trigger 54 from gear train 102 andreset the staple firing system. In at least one embodiment, cam 68 andratchet gear 108 can be manually reset, however, referring primarily toFIGS. 3-5, 9, 10, 19 and 20, surgical instrument 50 can include a resetsystem which can automatically reset the end effector closure system andstaple firing system described above. In various embodiments, the finalreturn actuation of trigger 54 can reset these systems as described indetail below.

As outlined above, the first actuation of trigger 54 can rotate cam 68into the position illustrated in FIG. 8 and spring lock 92 can beconfigured to hold cam 68 in place as the firing drive is operated bysubsequent actuations of trigger 54. As also illustrated in FIG. 8,surgical instrument 50 can further include cam spring 67 which can beconfigured to bias cam 68 downwardly and, referring to FIGS. 9 and 10,hold cam lock arm 73 extending from cam 68 against spring lock 92. Insuch embodiments, cam lock arm 73 can include recess 74 which can beconfigured to receive at least a portion of spring lock 92. In order toassist cam spring 67 in keeping cam 68 from lifting upwardly duringsubsequent actuations of trigger 54 and becoming disengaged from camspring 92, indicator nut 174 can be configured to contact cam rail 75and hold cam lock arm 73 against spring lock 92. More particularly, asindicator nut 174 is advanced distally, as described above, indicatornut 174 can be slid along contact rail 75 providing a positive stopagainst which cam 68 cannot rotate. Once indicator nut 174 is returnedto its most proximal position, however, indicator nut 174 can becomealigned with ramp 89 and, as a result, the third return actuation oftrigger 54 can cause cam 68 to rotate upward slightly, therebydisengaging lock arm 73 from spring lock 92 as illustrated in FIG. 10.

After cam 68 has been released from lock 92, cam return spring 67 can beconfigured to rotate cam 68 downwardly and return it to its originalposition. As cam 68 is rotated downwardly, the walls of cam slot 69 canbe configured to drive closure links 72 distally and, correspondingly,drive channel portions 78 and 80 and staple cartridge channel 64distally as well. In at least one embodiment, end effector 58 canfarther include a spring (not illustrated) configured to bias anvil 62upwardly as staple cartridge channel 64 is slid distally, i.e., awayfrom outer sheath 57 of elongate shaft assembly 56. In other variousembodiments, although not illustrated, surgical instrument 50 canfurther include an actuator in which a surgeon can operate to pull orpush anvil 62 into an open position. In either event, in at least oneembodiment, cam return spring 67 can assert a force sufficient for cam68 to displace ratchet gear 108 out of engagement with main drive gear110 and, as a result, reset the firing drive. In other variousembodiments, cam return spring 67 may not be strong enough to pull cam68 downwardly with sufficient force to disengage ratchet gear 108 frommain drive gear 110. In at least one such embodiment, surgicalinstrument 50 can further include, referring to FIGS. 3-5 and 19, atoggle switch assembly which can selectively bias ratchet gear 108 awayfrom main drive gear 110.

In various embodiments, referring primarily to FIGS. 3, 4, and 9, toggleswitch assembly 190 can include toggle actuator 192 mounted to driveshaft 106, where toggle actuator 192 can include toggle arm 193extending therefrom. Upon the final return actuation of trigger 54, inat least one embodiment, indicator nut 172 can contact toggle actuator192 and rotate it about drive shaft 106 such that toggle arm 193 isrotated toward ratchet gear 108. In at least one such embodiment,referring to FIG. 9, indicator nut 172 can further include ramp 179which can be configured to engage projection 191 extending from toggleactuator 192 and rotate toggle actuator 192 clockwise about drive shaft106. In various embodiments, toggle arm 193 can be configured to contactratchet gear 108 as it is rotated about drive shaft 106 and displaceratchet gear 108 away from main drive gear 110. In at least oneembodiment, ratchet gear 108 can be sufficiently displaced away fromdrive gear 110 to allow cam return spring 67 to position cam 68 adjacentcollar 118. Thereafter, cam 68 can hold ratchet gear 108 in thisposition until cam 68 is rotated upwardly as described above.

Although the above-described mechanisms can reset cam 68 and ratchetgear 108 into their initial positions, toggle arm 193 of toggle actuator192, at least in the illustrated embodiment, can remain positionedagainst collar 118 of ratchet gear 108. Accordingly, even if cam 68 isrotated upwardly such that groove 120 is aligned with collar 118 uponthe first actuation of trigger 54, ratchet gear 108 may not be releasedto engage main drive gear 110 as described above. In view of this, in atleast one embodiment, surgical instrument 50 can include a resetmechanism for rotating toggle arm 193 out of engagement with ratchetgear 108. Such a mechanism can, in various embodiments, be manuallyoperated and/or automatically operated in response to an actuation oftrigger 54, for example. In at least one embodiment, as illustrated inFIG. 20, housing 90 can include projection 91 extending therefrom whichcan be configured to rotate toggle actuator 192 about drive shaft 106and return it to its original, unactuated position as illustrated inFIG. 9. More particularly, in various embodiments, projection 91 can beconfigured to engage toggle link 194 (FIG. 3) as gear carriage 130 ismoved from its distal position in which reversing gear 136 is engagedwith bevel gear 114 to its proximal position in which forward gear 134is engaged with bevel gear 114. Such movement can be effected byswitching mechanism 160 when shifter handles 164 are rotated downwardlyto move gear carriage 130 proximally and place surgical instrument 50 inits ‘advancing’ configuration described above. As a result of thecontact between toggle link 194 and projection 91, toggle link 194 canbe rotated about pin 195 such that toggle link 194 contacts actuator arm193 and rotates toggle actuator 192 counterclockwise about drive shaft106. In various embodiments, toggle switch assembly 190 can furtherinclude bistable compliant mechanism 196, which can assist in assuringthat toggle switch assembly 190 does not become stuck in an intermediateconfiguration.

As described above, surgical instruments in accordance with the presentinvention can include a single trigger for actuating both an endeffector closure system and a staple firing system. While theabove-described features were described in connection with such singletrigger surgical instruments, several of the features described abovecan be used in surgical instruments having a first trigger for actuatingan end effector closure system and a second trigger for actuating astaple firing system. Referring to FIGS. 23-30, for example, surgicalinstrument 200 can include trigger 201 for actuating an end effectorclosure system and trigger 204 for actuating a staple firing system. Invarious embodiments, referring to FIG. 25, the end effector closuresystem can include closure link 203 operably engaged with closuretrigger 201 via pin 209. The end effector closure system can furtherinclude slider 205 and closure tube 207 (FIG. 23), where closure tube207 can be operably connected to closure link 203 via slider 205 and pin211. More particularly, referring to FIG. 29, closure tube 207 caninclude flange 213 at its most proximal end which can be configured tobe received within slot 215 in slider 205 such that the sliding motionof slider 205 is transmitted to closure tube 207.

In use, referring primarily to FIGS. 29 and 30, the actuation of trigger201 can translate closure link 203 distally and, correspondingly,translate slider 205 and closure tube 207 distally as well. In variousembodiments, closure tube 207 can include features which arecooperatively engaged with anvil 62 such that translation of closuretube 207 causes anvil 62 to rotate toward staple cartridge channel 64.More particularly, referring to FIG. 24, anvil 62 can include projection51 extending therefrom which can be received within aperture 217 ofclosure tube 207 such that sidewalls of aperture 217 can abut projection51 and rotate anvil 62 downwardly. To guide anvil 62, as outlined above,staple cartridge channel 64 can include slots 65 which can define a pathfor anvil 62 as it is rotated. Surgical instrument 200 can furtherinclude lock 219 which can be configured to hold trigger 201 in anactuated position thereby holding anvil 62 in a closed position. To openanvil 62, lock 219 (FIG. 28) can be disengaged from trigger 201 suchthat trigger 201 can be returned to its unactuated position. As trigger201 is returned to its unactuated position, trigger 201 can drive slider205 and closure tube 207 proximally and, owing to the operativeengagement between projection 51 and aperture 217, rotate anvil 62upwardly.

As indicated above, surgical instruments in accordance with the presentinvention can include a firing drive which can be configured to advancea cutting member, for example, at a first rate and retract the cuttingmember at a different rate. In various embodiments, referring to FIGS.23-30, surgical instrument 200 can include firing drive 202 which cancomprise trigger 204, drive shaft 206, first ratchet assembly 210, andsecond ratchet assembly 212. In at least one embodiment, ratchetassemblies 210 and 212 can be configured to rotate drive shaft 206 inclockwise and counter-clockwise directions, respectively, in order toadvance or retract cutting member 96 within end effector 58. In variousembodiments, referring to FIG. 25, trigger 204 can be selectivelyengageable with ratchet assemblies 210 and 212 such that, when trigger204 is actuated, only one of ratchet assemblies 210 and 212 is driven bytrigger 204. In at least one such embodiment, trigger 204 can beslidable along pin 214 in order to engage trigger 204 with one ofratchet assemblies 210 and 212. In the illustrated embodiment, pin 214can be rotatably received in apertures 216 in housing portions 218 andprovide an axis of rotation for trigger 204.

In various embodiments, referring to FIG. 27, trigger 204 can bepositioned such that pawl 220, which can be pivotably mounted to trigger204, is engaged with ratchet wheel 222 and, upon the actuation oftrigger 204, ratchet wheel 222 is rotated about pin 214 by pawl 220.Upon the release of trigger 204, pawl 220 can slide over ratchet teeth224 of ratchet wheel 222 permitting relative movement therebetween. Inat least one embodiment, ratchet assembly 210 can further include a pawlspring (not illustrated) configured to bias pawl 220 into engagementwith ratchet teeth 224 and re-engage pawl 220 with ratchet teeth 224when trigger 204 is reactuated. In order to transmit the rotation ofratchet wheel 222 to drive shaft 206, drive shaft 206 can includeforward gear 226 connected thereto. More particularly, in at least oneembodiment, ratchet wheel 222 can further include gear teeth 228 whichcan be operably engaged with forward gear 226 such that the rotation ofratchet wheel 222 rotates forward gear 226 and drive shaft 206 aboutaxis 230 (FIG. 25). In various embodiments, forward gear 226 can bepress-fit, for example, onto drive shaft 206 or, in other variousembodiments, forward gear 226 can be integrally formed with drive shaft206.

In various embodiments, similar to the surgical instruments describedabove, drive shaft 206 can, referring to FIG. 24, be operably engagedwith firing nut 140 in order to translate firing nut 140 within proximalretainer portion 232. As also described above, the translation of firingnut 140 can be transmitted to cutting member 96 via drive bar 146 inorder to advance cutting member 96 within end effector 58. In order toretract cutting member 96 within end effector 58, in at least oneembodiment, trigger 204 can be slid into engagement with second ratchetassembly 212 such that drive shaft 206 is rotated in the oppositedirection when trigger 204 is actuated. Similar to ratchet assembly 210,referring to FIG. 28, ratchet assembly 212 can include ratchet wheel 234and pawl 236 where pawl 236 can be pivotably mounted to trigger 204 andcan be operatively engaged with ratchet wheel 234 via ratchet teeth 238.Similar to ratchet wheel 222, ratchet wheel 234 can include gear teeth240 which can be operably engaged with reversing gear 242 mounted todrive shaft 206. As ratchet wheels 222 and 234 engage drive shaft 206 onsubstantially opposite sides, ratchet wheels 222 and 234 can rotatedrive shaft 206 in opposite directions, i.e. clockwise andcounter-clockwise directions, respectively. Thus, in order to selectwhether cutting member 96 is advanced or retracted within end effector58, trigger 204 can be slid into operative engagement with either firstratchet assembly 210 or second ratchet assembly 212.

In various embodiments, although not illustrated, first ratchet wheel222 and second ratchet wheel 234 can have substantially the samediameter, or pitch radius. Stated another way, the distance between thecenter, or axis of rotation, of the ratchet wheels and the gear teeth ofthe ratchet wheels can be the same. In such embodiments, the distancethat cutting member 96 is advanced per actuation of trigger 204 will besubstantially the same distance that cutting member 96 is retracted peractuation of trigger 204. While suitable in some circumstances, suchembodiments may require a surgeon to actuate trigger 204 several timesbefore cutting member 96 is completely retracted. In view of the above,in various embodiments, first ratchet wheel 222 can have a pitch radiuswhich is different than the pitch radius of second ratchet wheel 234. Inat least one embodiment, second ratchet wheel 234 can have a largerpitch radius than first ratchet wheel 222 such that cutting member 96 isretracted a distance per actuation of trigger 204 which is greater thanthe distance that cutting member 96 is advanced per actuation of trigger204. Stated another way, second ratchet assembly 212 can, at least inthese embodiments, retract cutting member 96 at a rate which is greaterthan which it is advanced. In such embodiments, first ratchet assembly210 can, owing to the slower advancing rate, provide a greater torque oradvancing force to cutting member 96 while second ratchet assembly 212can, owing to the faster retracting rate, reduce the time required forthe surgeon to retract the cutting member.

While the term ‘rate’, as used above, is used to describe the distancethat cutting member 96 can be advanced or retracted per actuation oftrigger 204, the term ‘rate’ is not so limited. In at least oneembodiment, the term ‘rate’ can be used to describe the velocity and/oracceleration in which the cutting member is moved. In such embodiments,it may be desirable to have a cutting member which is advanced at alower velocity and/or acceleration to better control the cutting memberand retracted at a greater velocity and/or acceleration to reduce thetime required to retract the cutting member. Furthermore, while theillustrated embodiments include ratchet assemblies for providing thedifferent advancing and retracting rates, the invention is not solimited. On the contrary, other embodiments are envisioned which includespur gear trains, bevel gears, and/or other motion transmission devices.

In various embodiments, surgical instruments in accordance with thepresent invention may include a gearbox for increasing or decreasing therotational speed of the drive shaft. In at least one embodiment,referring to FIG. 25, surgical instrument 200 can further includegearbox 250 which can be operably positioned intermediate drive shaft206 and ratchet assemblies 210 and 212. In various embodiments, gearbox250 can be used to ‘gear down’ the speed of drive shaft 206 such thatshaft 206 turns at a slower speed than if gearbox 250 were not utilized.In alternative embodiments, a gearbox can be used to ‘gear up’ the speedof drive shaft 206 such that drive shaft 206 turns at a faster speed. Inat least one embodiment, gearbox 250 can include at least one set ofplanetary gears for changing the speed of drive shaft 206. In othervarious embodiments, a gearbox, such as gearbox 252 illustrated in FIGS.21 and 22, can include housing 253, input gear 254 mounted to inputshaft 256, pinion gears 258, and output gear 260 mounted to output shaft262. In such embodiments, owing to the different pitch radii of inputgear 254 and output gear 260, input shaft 256 and output shaft 262 willrotate at different speeds. To facilitate the rotational movement ofgears 254, 258, and 260 within housing 253, gearbox 252 can furtherinclude various support plates 264, spacers 266, and pins 268 asillustrated in FIG. 22. In addition to the above, gearbox 252 can alsobe used to convert the clockwise motion of input shaft 256, for example,into counter-clockwise motion of output shaft 262.

In various embodiments described above, trigger 204 of surgicalinstrument 200 can be slid between a first position in which it isoperatively engaged with first ratchet assembly 210 and a secondposition in which it is operatively engaged with second ratchet assembly212. In at least one embodiment, firing drive 202 can be configured suchthat first pawl 220, for example, is disengaged from first ratchet wheel222 before second pawl 236 is engaged with second ratchet wheel 234. Insuch embodiments, trigger 204 may be positioned in an intermediateposition where it is not operably engaged with either first ratchetassembly 210 or second ratchet assembly 212. In various embodiments, asa result, firing drive 202 can be in a ‘free’ state where the actuationof trigger 204 does not result in the rotation of drive shaft 206. Inalternative embodiments, firing drive 202 can be configured such thatsecond pawl 236, for example, is engaged with second ratchet wheel 234before first pawl 220 is operatively disengaged from first ratchet wheel222. In such embodiments, trigger 204 may be positioned in anintermediate ‘locked’ state where trigger 204 cannot be actuated,thereby indicating to the surgeon that trigger 204 is not completelyengaged with either one of the ratchet assemblies and trigger 204requires further adjustment.

In various embodiments, surgical instrument 200 can include a devicewhich biases trigger 204 into engagement with one of first ratchetassembly 210 and second ratchet assembly 212. In at least oneembodiment, referring to FIG. 33, surgical instrument 200 can furtherinclude bistable compliant mechanism 270 which can bias trigger 204 outof an intermediate position described above and into engagement witheither first ratchet assembly 210 and second ratchet assembly 212. Invarious embodiments, bistable compliant mechanism 270 can include spring272 and link 274, where spring 272 can apply a biasing force to trigger204 via link 274 such that the biasing force acts to move trigger 204out of its intermediate position illustrated in FIG. 33 and intoengagement with either first ratchet wheel 222 or second ratchet wheel234. More particularly, when trigger 204 is positioned in itsintermediate position, spring 272 can be stretched to a length X1 and,owing to the resiliency of spring 272, spring 272 can seek to shortenitself to its unstretched length, or at least a length shorter than X1,such as length X2 for example. In order for spring 272 to shorten itselfto length X2, spring 272 can rotate link 274 about pin 275 where pin 275can extend from and pivotably mount link 274 to surgical instrumenthousing 218. More particularly, as the first end of spring 272 ismounted to pin 276 extending from housing 218 and the second end ofspring 272 is mounted to pin 277 extending from link 274, spring 272 canshorten itself by moving pin 277 closer to pin 276 which is most easilyaccomplished by rotating link 274 about pin 275. As link 274 is rotatedabout pin 275, the side walls of slot 278 in link 274 can be configuredto engage pin 279 extending from trigger 204 and slide trigger 204 intoengagement with first ratchet wheel 222 or second ratchet wheel 234. Ineffect, the intermediate position of trigger 204 illustrated in FIG. 33represents a dynamically unstable position and the positions of trigger204 where trigger 204 is engaged with ratchet wheels 222 and 234represent the dynamically stable positions of the firing drive system.

In various embodiments, as described above, surgical instruments inaccordance with the present invention can include devices for rotating adrive shaft in a first direction in which the drive shaft advances acutting member within an end effector, for example, and a seconddirection in which the drive shaft retracts the cutting member. In atleast one embodiment, referring to FIGS. 31 and 32, a surgicalinstrument can include transmission 280, for example, which can allow asurgeon to select whether the drive shaft advances or retracts thecutting member. In various embodiments, transmission 280 can includehousing 282, internal input shaft 284, external input shaft 285, outputdrive shaft 286, and switching mechanism 288, where switching mechanism288 can be configured to selectively engage internal input shaft 284 andexternal input shaft 285 with output shaft 286. Although notillustrated, the surgical instrument can further include a trigger, forexample, which is operatively engaged with external drive shaft 285 inorder to rotate drive shaft 285 about axis 287 in a clockwise direction,for example. In at least one embodiment, transmission 280 can includepinion gears 292 rotatably mounted within housing 282, input gear 293fixedly mounted to external input shaft 285, and output gear 294 mountedto output drive shaft 286, where input gear 293 can be operably engagedwith outer gear teeth 290 of pinion gears 292 such that the rotation ofexternal shaft 285 is transmitted to pinion gears 292.

In a first configuration of transmission 280, output gear 294 can beoperatively engaged with inner gear teeth 291 of pinion gears 292 suchthat the rotation of pinion gears 292 is transmitted to output driveshaft 286. More particularly, output gear 294 can be operably engagedwith output drive shaft 286 via splined end 296 such that output gear294 drives output drive shaft 286 about axis 287. In this firstconfiguration, a clockwise rotation of external input shaft 285, forexample, can be converted into a counter-clockwise motion of outputdrive shaft 286. In a second configuration of transmission 280, outputgear 294 can be disengaged from pinion gears 292 such that the rotationof external input shaft 285 is not transmitted to output drive shaft 286via pinion gears 292. In order to disengage output gear 294 from piniongears 292, internal drive shaft 284 can be slid relative to externaldrive shaft 285 such that input gear 297 contacts recess 298 in outputgear 294 and pushes output gear 294 away from pinion gears 292. In atleast one embodiment, recess 298 can include teeth 299 which can beoperatively engaged with input gear 297 of internal input shaft 284 suchthat the rotation of internal input shaft 284 is transmitted to outputdrive shaft 286. In this second configuration of transmission 280, aclockwise rotation of internal input shaft 284 can be directlytransmitted to output drive shaft 286 such that output shaft 286 rotatesin a clockwise direction as well. In order to reengage output gear 294with pinion gears 292, internal input gear 284 can be disengaged fromoutput gear 294 to allow spring 281 to slide output gear 294 alongsplined end 296.

In the embodiments described above, a surgeon can selectively moveinternal input shaft 284 relative to external input shaft 285 to placetransmission 280 in either a forward or reversing configuration. Inorder to move input shaft 284, in various embodiments, the surgicalinstrument can further include an actuator or trigger configured totranslate internal input shaft 284. In at least one embodiment, thesurgical instrument can include a first actuator or trigger for rotatingexternal input shaft 285 and a second actuator or trigger fortranslating internal shaft 284 relative to external shaft 285. In suchembodiments, internal input shaft 284 can include splines 283 which canbe slidably engaged with external input shaft 285 such that the rotationof external shaft 285 is transmitted to internal shaft 284 yet slidingmotion is permitted therebetween. In at least one embodiment,transmission 280 can further include bearing 300 which can rotatablysupport input gear 293 and, when compressed between input gear 293 andhousing 282, provide a biasing force to keep input gear 293 operablyengaged with pinion gears 292. In various embodiments, output shaft 286can include member 302 extending therefrom which can be configured to bereceived within recess 301 of housing 282 in order to reduce, or eveneliminate, relative movement between output shaft 286 and housing 282.In at least one embodiment, although not illustrated, transmission 280may only have one pinion gear 292 and still operate in the mannerdescribed above.

In various embodiments, transmission 280 can also be configured toadvance cutting member 96, for example, at a different rate than whichit is retracted. In at least one embodiment, referring to FIGS. 31 and32, the operative engagement between internal input shaft 284 and outputshaft 286 can be used to advance cutting member 96 and, owing to thedirect engagement between input gear 297 and output gear 294, internalinput shaft 284 and output shaft 286 can rotate in a 1:1 ratio, i.e.,for every rotation of internal input shaft 284, output shaft 286 isrotated once. In various embodiments, the operative engagement betweenexternal input shaft 285 and output shaft 286 can be used to retractcutting member 96 and, owing to the different pitch radii of input gear293 and output gear 294 and their operative engagement with pinions 292,external input shaft 285 and output shaft 286 can rotate in a ratiodifferent than 1:1. In the illustrated embodiment, output shaft 286 canrotate at a faster speed than external input shaft 285 when they aremated via pinions 292. In various embodiments, as a result, cuttingmember 96 can be translated at a faster rate when external input shaft285 is operably engaged with output shaft 286 than when internal inputshaft 284 is operably engaged with output shaft 286.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Those.skilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Preferably, the invention described herein will be processed beforesurgery. First, a new or used instrument is obtained and if necessarycleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK bag. The container and instrument are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or high-energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples. Further, this application is intended to cover suchdepartures from the present disclosure as come within known or customarypractice in the art to which this invention pertains.

1. A surgical instrument, comprising: a handle; a trigger operablycoupled to said handle; a closure drive operatively engaged with saidtrigger, wherein said closure drive is configured to generate a closingmotion upon a first actuation of said trigger; a firing drive, whereinsaid firing drive is not operably engaged with said trigger prior tosaid first actuation of said trigger, wherein said firing drive isconfigured to engage said trigger as a result of said first actuation,and wherein said firing drive is configured to generate a firing motionupon a second actuation of said trigger; an elongate shaft assemblycoupled to said handle, wherein said elongate shaft assembly is operablyengaged with said firing drive; and an end effector coupled to saidelongate shaft assembly, said end effector comprising: an elongatechannel configured to operably support a staple cartridge therein; ananvil movably coupled to said elongate channel, wherein said anvil isoperably engaged with said closure drive and is movably responsive tosaid closing motion; and a cutting member operably supported within saidelongate channel, wherein said cutting member is operably engaged withsaid elongate shaft assembly and is responsive to said firing motionfrom said firing drive.
 2. The surgical instrument of claim 1, whereinsaid firing drive is further configured to generate a retraction motionupon an other actuation of said trigger, and wherein said cutting memberis responsive to said retraction motion from said firing drive.
 3. Thesurgical instrument of claim 1, wherein said elongate shaft assemblyincludes a rotatable drive shaft, and wherein said firing drive isconfigured to transmit rotary firing motion to said drive shaft.
 4. Thesurgical instrument of claim 1, wherein said trigger further includes atrigger gear portion, wherein said firing drive further includes a drivegear and an intermediate gear, wherein said drive gear is operativelyengaged with said elongate shaft assembly to transmit said firing motionto said cutting member, wherein said intermediate gear is not operablyengaged with said drive gear prior to said first actuation of saidtrigger, and wherein said intermediate gear is operably engaged withsaid trigger gear portion and said drive gear as a result of said firstactuation of said trigger.
 5. The surgical instrument of claim 4,wherein said intermediate gear includes a first ratchet face, whereinsaid drive gear further includes a second ratchet face, and wherein saidfiring drive further includes a spring configured to bias said firstratchet face of said intermediate gear into operative engagement withsaid second ratchet face of said drive gear.
 6. The surgical instrumentof claim 4, wherein said firing drive further includes a springconfigured to bias said intermediate gear into operative engagement withsaid drive gear, wherein said closure drive further includes a cam, andwherein said cam is configured to bias said intermediate gear out ofengagement with said drive gear prior to said first actuation of saidtrigger and release said intermediate gear prior to said secondactuation of said trigger.
 7. The surgical instrument of claim 6,wherein said cam is movable between a first position and a secondposition as a result of said first actuation of said trigger, andwherein said closure drive further includes a lock configured to holdsaid cam in said second position during said second actuation of saidtrigger.
 8. The surgical instrument of claim 7, wherein said firingdrive is further configured to generate a retraction motion upon another actuation of said trigger, wherein said cutting member isresponsive to said retraction motion from said firing drive, whereinsaid firing drive is configured to release said cam from said lock as aresult of said other actuation, wherein said closure drive furtherincludes a return spring connected to said cam and said handle, andwherein said return spring is configured to return said cam to saidfirst position.
 9. The surgical instrument of claim 8, wherein saidfiring drive is further configured to disengage said intermediate gearfrom said drive gear as a result of said other actuation of said triggerand reposition said cam to bias said intermediate gear out of operativeengagement with said drive gear.
 10. A method for processing aninstrument for surgery, the method comprising: obtaining the surgicalinstrument of claim 1; sterilizing the surgical instrument; and storingthe surgical instrument in a sterile container.
 11. A surgicalinstrument, comprising: a handle; a trigger operably coupled to saidhandle; a closure drive operatively engaged with said trigger, whereinsaid closure drive is configured to generate a closing motion upon afirst actuation of said trigger; a firing drive operatively engaged withsaid trigger, wherein said firing drive is configured to generate afiring motion upon a second actuation of said trigger, and wherein saidfiring drive is further configured to generate a retraction motion uponan other actuation of said trigger; an elongate shaft assembly coupledto said handle, wherein said elongate shaft assembly is operably engagedwith said firing drive; and an end effector coupled to said elongateshaft assembly, said end effector comprising: an elongate channelconfigured to operably support a staple cartridge therein; an anvilmovably coupled to said elongate channel, wherein said anvil is operablyengaged with said closure drive and is movably responsive to saidclosing motion; and a cutting member operably supported within saidelongate channel, wherein said cutting member is operably engaged withsaid elongate shaft assembly and is responsive to said firing and saidretraction motions from said firing drive.
 12. The surgical instrumentof claim 11, wherein said closure drive further includes a cam operablyengaged with said trigger, wherein said closure drive further includes adrive link operably engaged with said cam and said anvil, and whereinsaid cam is configured to motivate said drive link upon said firstactuation of said trigger and pivot said anvil into a closed position.13. The surgical instrument of claim 12, wherein said cam is movablebetween a first position and a second position as a result of said firstactuation of said trigger, and wherein said closure drive furtherincludes a lock configured to retain said cam in said second positionduring said second actuation of said trigger.
 14. The surgicalinstrument of claim 13, wherein said firing drive is configured torelease said cam from said lock as a result of said other actuation,wherein said closure drive further includes a return spring connected tosaid cam and said handle, and wherein said return spring is configuredto return said cam to said first position.
 15. The surgical instrumentof claim 12, wherein said firing drive further includes a drive memberoperably engaged with said elongate shaft assembly, and wherein saiddrive member is selectively engaged with said trigger to transmit saidfiring motion to said cutting member.
 16. The surgical instrument ofclaim 15, wherein said cam is configured to bias said firing drive outof engagement with said trigger in a first condition and release saidfiring drive to engage said trigger in a second condition.
 17. Thesurgical instrument of claim 11, wherein said firing drive is notoperably engaged with said trigger prior to said first actuation of saidtrigger, and wherein said firing drive is configured to engage saidtrigger as a result of said first actuation.
 18. A method for processingan instrument for surgery, the method comprising: obtaining the surgicalinstrument of claim 11; sterilizing the surgical instrument; and storingthe surgical instrument in a sterile container.
 19. A surgicalinstrument, comprising: a handle; a trigger operably coupled to saidhandle; a closure drive operatively engaged with said trigger, whereinsaid closure drive is configured to generate a closing motion upon afirst actuation of said trigger; a firing drive operatively engaged withsaid trigger, wherein said firing drive is configured to generate afiring motion upon a second actuation of said trigger, and wherein saidfiring drive is further configured to generate a second firing motionupon a third actuation of said trigger; an elongate shaft assemblycoupled to said handle, wherein said elongate shaft assembly is operablyengaged with said firing drive; and an end effector coupled to saidelongate shaft assembly, said end effector comprising: an elongatechannel configured to operably support a staple cartridge therein; ananvil movably coupled to said elongate channel, wherein said anvil isoperably engaged with said closure drive and is movably responsive tosaid closing motion; and a cutting member operably supported within saidelongate channel, wherein said cutting member is operably engaged withsaid elongate shaft assembly and is responsive to said first and secondfiring motions from said firing drive.
 20. A method for processing aninstrument for surgery, the method comprising: obtaining the surgicalinstrument of claim 19; sterilizing the surgical instrument; and storingthe surgical instrument in a sterile container.